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Zestril 5mg is a medicine for the treatment of congestive heart failure, hypertension, myocardial infarction and diabetic patients with kidney complications. Zestril 5 mg should be used in the correct dosage as directed by your doctor to avoid dangerous side effects to health.1. What is Zestril 5mg?
Zestril 5mg drug has the main ingredient lisinopril dihydrate - an angiotensin-converting enzyme inhibitor. The drug has a brand origin from the UK, used to treat cases of acute myocardial infarction, congestive heart failure or hypertension. In addition, zestril 5mg is also indicated for the treatment of kidney complications in patients with diabetes mellitus.Zestril 5mg is available as an uncoated, round, pink and biconvex tablet. One side has a broken line, the other side is engraved with the mark “♥5”. Zestril 5mg is packaged in a box of 2 blisters x 14 tablets.
2. Composition, uses and indications for use of zestril 5mg
2.1 Composition information of zestril 5mg Each tablet of zestril 5mg contains the main ingredient lisinopril, with the equivalent content of 5mg.2.2 Uses of zestril 5mg Pharmacodynamics:
Lisinopril in zestril 5mg inhibits angiotensin-converting enzyme (ACE) - an endogenous enzyme capable of converting angiotensin I to angiotensin II (a vasoconstrictor peptide). In response to increased renin, angiotensin I is elevated in certain conditions such as kidney disease or heart failure. The vasoconstrictor peptide stimulates the adrenal cortex to secrete aldosterone, which increases myocardial growth, leading to vasoconstriction, myocardial hypertrophy, and hypertension.
The angiotensin-converting enzyme inhibition of lisinopril helps to reduce levels of aldosterone and angiotensin II. This helps to dilate peripheral vessels, reducing fluid retention, sodium retention, and peripheral resistance.
Many believe that the antihypertensive effect of lisinopril is mainly due to its ability to inhibit the angiotensin-renin-aldosterone system. However, this component of zestril 5mg is still effective in treating high blood pressure in people with low renin levels. An ACE inhibitor is similar to the enzyme that degrades bradykinin (kininase II). The role of increased bradykinin concentration in the therapeutic effect of lisinopril is still a big question mark that needs to be elucidated.
Pharmacokinetics:
Absorption
Zestril 5mg after oral administration will be absorbed at a slow rate and not completely through the gastrointestinal tract. Each person will have a different rate of absorption of lisinopril, usually ranging from 6 - 60% corresponding to the doses of 5 - 80 mg according to the study. Overall, the mean extent of lisinopril absorption will be in the range of 25%, estimated based on the amount of drug absorbed in the urine.
In patients with heart failure, the absolute bioavailability of lisinopril is reduced by about 18%. Because lisinopril itself is active, it does not need to go through the same metabolism as some other ACE inhibitors when it enters the body. Zestril 5 mg will reach peak serum concentrations after about 7 hours and continue to work for 24 hours. However, peak blood levels of the drug in patients with acute myocardial infarction tend to be slower. On the other hand, the food that the patient consumes on a daily basis does not have a great impact on the absorption of lisinopril from the gastrointestinal tract.
Distribution
The lisinopril component in zestril 5mg is not bound to plasma proteins other than ACE.
Elimination
Zestril 5mg is completely eliminated in the urine as unchanged drug because it is not metabolized. For repeated doses, the cumulative effective half-life of lisinopril is 12.6 hours. In healthy subjects, the drug clearance is about 50 ml/min. Serum concentrations of lisinopril tend to decrease gradually, which indicates a prolonged terminal phase and manifests by saturation binding to the angiotensin-converting enzyme inhibitor and is not dose proportional.
In patients with renal impairment, the elimination of the drug is reduced, while the absorption of lisinopril is reduced in cirrhotic patients, but the extent and duration of exposure to the drug is increased. For patients with heart failure, there will be a greater level and duration of drug exposure, but reduced absorption compared to people in good health.
2.3 Indication to use zestril 5mg medicine Zestril 5mg is usually indicated for use in the following cases:
Treatment of hypertension: Zestril 5mg is often prescribed by doctors for patients with high blood pressure. due to renal vascular disease or essential hypertension. This medication can be used alone or in combination with other high blood pressure medications as directed by your doctor. Treatment of congestive heart failure: Zestril 5mg is indicated for symptomatic cases of congestive heart failure. In addition, the drug also supports the effect of digitalis or diuretics in certain cases. Treatment of acute myocardial infarction: For patients with acute myocardial infarction who are hematologically stable within the first 24 hours, short-term treatment with zestril 5 mg for 6 weeks is indicated to help prevent systemic caused by heart failure, left ventricular dysfunction, and improved survival for patients. Zestril 5 mg may be used in combination with a beta-blocker or a thrombolytic agent aspirin. Treatment of kidney complications in people with diabetes: Zestril is indicated for the treatment of kidney complications in insulin-dependent (normal blood pressure) or non-diabetic patients. insulin (have elevated blood pressure levels with early kidney disease). Using zestril may decrease the rate at which albuminuria is produced in the body.
3. In which case is Zestril 5mg contraindicated?
Children 6 years and older and adults can use zestril 5 mg, but this medicine should not be used in the following cases:
People who are allergic to lisinopril or hypersensitive to any other drug. any ingredient of the drug. Patients with a history of angioedema due to previous treatment with certain ACE inhibitors. People with idiopathic or hereditary angioedema. Patients with obstructive cardiomyopathy, renal artery stenosis in a single kidney or both. Patients with aortic valve stenosis. Women who are pregnant. Women who are in the lactation period. People who are taking medicines containing aliskiren to treat type 1 or type 2 diabetes or kidney failure. People who are about to undergo surgery under general anesthesia, have kidney or blood problems (leukopenia), have recently experienced severe vomiting and diarrhea, should use Zestril 5 mg with caution. .
4. Dosage and how to use Zestril 5mg
4.1 Dosage of Zestril 5mg for each subject Due to the composition of zestril 5mg drug, lisinopril (ACE inhibitor) has a long effect, so patients only take the drug orally with a dose of 1 time / day. Specifically:Dosage for people with essential hypertension:
Initial dose: Take 10mg / time / day. Maintenance dose: Take 20mg / time / day. The dose can be adjusted according to the response of the patient's blood pressure. If the therapeutic effect is not as desired after 2-4 weeks of using the drug, the patient can increase the maximum dose up to 80 mg / day.
People on diuretic therapy should stop using this medicine 2-3 days before starting zestril. In cases where the diuretic cannot be stopped, patients with hypertension should take zestril at an initial dose of 5 mg.
In patients with renal impairment, the starting dose of zestril will be based on creatinine clearance (ml/min), including:
2.5 mg dose for creatinine clearance less than 10 ml/min. Doses range from 2.5 to 5 mg for a creatinine clearance of 10 to 30 ml/min. Doses range from 5 to 10 mg for a creatinine clearance of 31 to 70 ml/min. Dosage and frequency of administration of zestril 5 mg will be adjusted based on blood pressure response. The dose may be increased gradually until blood pressure is controlled or to a maximum dose of 40 mg/day.
Dosage for patients with hypertension due to renal vascular disease:
The starting dose is usually lower than 2.5 - 5 mg. The dose of zestril will be adjusted based on blood pressure response.
Dosage for people with congestive heart failure:
Starting dose: 2.5 mg/day. The usual effective dose is 5 - 20 mg/day/dose. For patients with congestive heart failure requiring greater efficacy, the dose may be adjusted every 4 weeks based on clinical response. Patients at risk for hypotension, hypovolaemia, or already on active diuretic therapy may be able to correct these disturbances prior to the administration of zestril 5 mg.
Dosage for patients with acute myocardial infarction:
People with acute myocardial infarction may be prescribed to start using zestril 5mg within 24 hours (from the time of onset of symptoms). Doses should be used continuously for 6 weeks to achieve the best effect. Specifically:
Starting dose: Take 5 mg. After 24 hours: Take 5 mg. After 48 hours: Take 10 mg. Subsequent days: Take 10 mg. People with a blood pressure of 120 mmHg should take zestril at a low dose of 2.5 mg as initial therapy or within the first 3 days after symptoms of infarction. In cases of systolic blood pressure below 100 mmHg, the patient should temporarily reduce the daily maintenance dose to 2.5 mg. If systolic blood pressure below 90 mmHg persists for more than one hour, the patient should not continue taking the drug.
Dosage for diabetics with renal complications:
The usual daily dose of zestril for diabetics with insulin-dependent normal blood pressure is 10 mg/day. However, if necessary, the dose can be increased to 20 mg/day to achieve a seated diastolic blood pressure below 75 mmHg. For diabetic patients with non-insulin dependent hypertension, the above dosage can be applied to achieve below 90 mmHg of diastolic blood pressure in the sitting position.
Dosage of zestril 5 mg for children 6 - 16 years old with high blood pressure:
Initial dose (children 20 - under 50 kg): Take 2.5 mg / time / day. Initial dose (children 50 kg or more): Take 5 mg / time / day. Depending on the individual, the dose can be adjusted up to a maximum of 20 mg/day (for children aged 20 - less than 50 kg) and less than 40 mg/day (for children over 50 kg). Children with impaired renal function should be cautious when taking a lower starting dose or gradually increasing the dosage levels as directed by the doctor.
4.2 How to use zestril 5mg medicine Zestril 5mg can be taken with or without food as directed by your doctor. Dosage will be based on the patient's medical condition and response to treatment. The drug is usually taken once a day and should be started at a low dose, then gradually increased as prescribed by your doctor to reduce the risk of side effects.
In the process of using the drug, the patient should strictly follow the doctor's recommendations, and take the drug regularly to achieve the highest effectiveness. To avoid missing a dose, you need to take it at the same time every day and continue to take it even when you feel well.
For patients with high blood pressure, it may take 2 to 4 weeks of taking zestril 5mg to see a noticeable effect that the drug brings. Meanwhile, patients being treated for heart failure can take weeks to months to get the full benefits of the drug. In addition, the patient needs to report his results to the doctor if his health condition shows no signs of positive change, such as blood pressure readings are still raised / higher than normal.
5. What to do if you take an overdose or miss a dose of zestril 5mg?
5.1 How to deal with an overdose of zestril 5mg Overdose of zestril 5mg can lead to dangerous symptoms such as circulatory shock, hypotension, shortness of breath, electrolyte disturbances, tachycardia, tachycardia slow heart rate, palpitations, kidney failure, cough, anxiety or dizziness. In case of overdose and the above symptoms, the patient should quickly call the nearest local health station for early treatment.Currently, the recommended treatment for an overdose of zestril 5mg is an intravenous infusion of 9% NaCl solution. In the case of hypertensive patients, place them in the anti-shock position and treat with intravenous catecholamines or angiotensin II if necessary.
If the patient has an overdose of the drug and has eaten before, the doctor can proceed to remove zestril from the patient's body by gastric lavage, induce vomiting or take an adsorbent - sodium sulfate. In addition, plasma electrolytes, vital signs, and creatinine levels are regularly monitored.
5.2 What to do when you miss a dose In the case of a missed dose, the patient needs to take the medicine as soon as possible. However, if it is too close to your next dose, it is best to skip the missed dose and take the next dose as directed by your doctor. You should avoid taking twice the prescribed dose as it can lead to an overdose.
6. Some side effects when using zestril 5mg
In fact, not everyone who takes zestril 5mg will experience unwanted side effects. However, knowing the side effects of medications can help patients deal with them as soon as they appear.
Common side effects of zestril 5mg:
According to research, the following side effects usually occur in about 1% of patients using zestril 5mg, including:
Headache, blurred vision, cough khan. Lightheadedness, dizziness, especially when sitting up or standing up too quickly during the initial dose or dose increase. Nausea, vomiting, diarrhea. Skin rash or mild itching. If the above side effects do not show signs of disappearing after a few days or worsen, the patient should immediately notify the doctor to have a timely remedy.
Serious but uncommon side effects of zestril 5mg:
These are rare but require immediate medical attention if you experience them after taking zestril 5mg, including:
Yellowing of eyes or skin . The person is pale, tired, dizzy, bleeding, fainting, has a high fever that does not go away, or a sore throat. Severe abdominal pain. Chest pain, wheezing, shortness of breath, heart palpitations. Blood in the urine, inability to urinate, swollen ankles. Difficulty speaking, weak limbs. Itching, swelling or peeling of the skin, swelling of the face/lips/tongue/mouth/throat.
7. Interactions of zestril 5mg with other drugs
Some drugs can interact with zestril 5mg and reduce the effectiveness of the treatment or increase the risk of side effects, including:
Anti-inflammatory drugs such as high-dose aspirin (>75 mg/day), ibuprofen or indomethacin. Medicines for heart failure, low blood pressure, asthma, or allergies such as adrenaline, noradrenaline, or ephedrine. Medicines that lower blood pressure (such as aliskiren), anti-anginal medicines, antidepressants, muscle relaxants (baclofen), medicines to treat an enlarged prostate, or anesthetics. Diuretics (furosemide). Anti-rejection drugs such as tacrolimus or cyclosporin. Drugs that cause hyperkalemia such as triamterene, spironolactone, or amiloride. Anticoagulants or potassium supplements. Medicines for diabetes, diarrhea (racecadotril), antipsychotics (lithium), allopurinol,... In addition, zestril can also interact with certain foods, tobacco and alcohol. Therefore, you need to consult your doctor before taking the drug along with the above factors.
8. How to store zestril 5mg
Here are some rules when storing zestril 5mg that you need to keep in mind, including:
Keep the medicine at room temperature, away from direct light and areas with high humidity, such as the bathroom. Do not store medicine in the freezer. Keep medication out of reach of children and pets. Avoid throwing medication down a drain or toilet unless asked to.
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